What drives Blue Cross' recent decison?

Moriba Karamoko

Recent news reports raise important questions about what motivated Blue Cross and Blue Shield of Louisiana to announce on Feb. 7 that they would no longer accept insurance payments from unrelated third parties. Subsequent company statements suggest that this new policy is a bit disingenuous, and hints of animus toward people living with HIV.

The issue here is the use of Ryan White funds by the state to help pay insurance premiums for people with HIV. Ryan White funding is the largest source of public funds specifically for people with HIV. Louisiana receives about $50 million to help people with HIV secure medical care and thereby slow the transmission of HIV. Blue Cross says as anti-fraud measure they will not accept checks from the State of Louisiana to help pay insurance premiums for people with HIV.

Really?

On Feb. 10 Blue Cross released a statement saying: "We are acting in the best interests of our current and future policyholders to take as many precautions against potential fraud, waste and abuse as we can, protecting the financial stability of our company and our customers' premium dollars."

Blue Cross acknowledges that only a "very few" of their customers are impacted by the new policy. In fact, as of January 2013 only 1,355 people with HIV had private insurance premiums paid for by the State of Louisiana, According to the Louisiana Department of Health and Hospitals.

Assuming these 1,355 policies were with Blue Cross, it would only represent 1 percent of the 128,413 individual policies Blue Cross has in effect. So, are we to believe that 1 percent or less of their business tied to people with HIV is a threat to the financial stability of the largest and most profitable insurance company in our state? Something doesn't add up.

These actions by Blue Cross smell like an attempt to exclude low and moderate income people with HIV from private insurance coverage, since people with HIV represent the largest and most identifiable group with a third party making premium payments on their behalf. At best this is a case of unintended consequences. At worst, it is a form of de-facto discrimination.

Finally, this policy undermines the public health imperative to slow the transmission of HIV by getting and keeping people with HIV in comprehensive medical care.

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What drives Blue Cross' recent decison?

Recent news reports raise important questions about what motivated Blue Cross and Blue Shield of Louisiana to announce on Feb. 7 that they would no longer accept insurance payments from unrelated